♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- We've got for you today five best at-home-
- Five.
- Hand and wrist stretches after surgery or cast removal
for pain-free movements.
Did I say that right?
- You did outstanding, Bob.
You're getting better every week.
- Before we get into it, though,
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- Oh Bob, you're killing me.
So, wrist.
You know, we just did a video on this,
on how to strengthen your wrist and I thought,
"Well, we better do something on how to actually loosen up,"
because before you strengthen it,
you should regain pretty much full range of motion.
- Brad, I must say, I think this is a very timely video
because we're just moving into winter
and how many times do you see this?
In the winter, somebody slips and the first thing they do?
They put their arm out and they break their wrist.
- That traditional Colles' fracture.
- Had a lot of them last year.
A neighbor lady did it
just walking out on her morning walk.
- I thought maybe she was getting the paper.
- Nope, she was going
and my wife's been using the Yaktrax.
- Oh yeah, for grip so you don't slip.
Anyways, we better get on with it.
We're rambling, Bob, I guess.
So, one thing that you really need to do
is after surgery or cast removal,
make sure you get the OK or the orders
from the physician that you're working with
on what to do or what not to do.
Hopefully, he's gonna say stretch it out as tolerated.
You should not create any sharp pain or get it swollen,
but work with it as appropriate
without overdoing it.
If that's the case, this is gonna be a really good video.
- You can do all these then.
- There may be precautions where, say,
you can flex it but you can't extend it
depending on the surgery,
but, you know, then you'll have to go with those.
- Go by the guidance of the therapist.
- And if that's the case,
you'll probably want to be with a therapist.
One thing I do want to say is that I had a person.
He cut his hand open right across the palm with a chainsaw.
Very severe.
And it was healed up fairly well but I had to be careful
on how much to do the range of motion
so you didn't split the incision open.
So, be careful of that too.
Make sure you got-
You know, clean up your hands and whatnot
so you don't get infection
if there was an incision with the surgery.
Stretch number one!
We're gonna start with the wrist.
Simple flexion
and extension.
And you'll probably wanna do it when you extend,
the fingers are gonna bend.
You'll get better range of motion as opposed to like this.
We're working the wrist, not the fingers now.
- If you're wanting to stretch the fingers,
then we'd go ahead and bring them up this way.
- So you're gonna work that
and you're gonna do 10 of all of these
throughout all of these.
Now,
I said that twice.
- You did, yeah.
- So anyways, if you wanna passively range your wrist,
you're gonna grab the hand here
to flex it.
You don't wanna grab the fingers;
we wanna isolate the wrist.
And you can do 10 this way.
You can grab here palm-to-palm
and extend this way to give a little more over pressure
if it's ready for it.
- Sometimes you can go off the edge of a table
just to give a little more support for the forearm.
- Right, stabilizes that forearm.
Good point, Bob.
The next one is-
Now this is something that is not maybe obvious to everyone,
but the wrist goes this way
but it also goes ulnar and radial deviation.
So, I like to grab my wrist here
and do this
and if it's not going very well,
grab like this and-
- Give it a little stretch.
Same thing again; you can go off the table
and work it that way too if you want to stabilize it.
- Again, 10 repetitions.
Not too fast; you can hold the stretch a little bit.
Hold it this way.
- Make sure you're breathing
and make sure your pain is under control.
- Right.
Don't get carried away.
Don't think no pain, no gain
and think you're gonna regain your motion in a couple days.
It may take a few weeks.
That all depends on how things are going for you
in your situation.
- Take what the body will give you
which may not be much to start.
- If it does swell up after some of these stretches,
cold packs for 10-20 minutes
is a good way to help control that.
The next one is pronation and supination.
So, palms up- supination.
Palms down- pronation.
You don't need to remember that unless you want to.
- Elbows are kind of in to the side I always think.
You don't want to go like that.
- Exactly.
Good point, Bob.
It's a good thing you're here today.
- Yeah, we're not doing the chicken dance here.
- Oh no, absolutely not.
I think that's a Wisconsin thing.
- I was so happy.
I just went to a wedding
and they didn't do the chicken dance.
I was so glad.
They didn't do the electric slide; they didn't do all those.
I was so glad.
- Now we're rambling, Bob.
We better get to the next one.
- But we're doing our exercises while we're rambling.
- Now this next one is really important for the fingers.
You really want to-
instead of just flexing and opening your fingers
which is a good way to start,
you want to actually go through each joint on the finger.
And I've done this a lot and I'll have my patients...
We're gonna start with the pointer finger.
You know, you can do this to get warmed up
but then grab here
right above that first joint
and go down and just isolate that joint.
- I would say, you would do this if they're stiff, right?
I mean, if they're fine,
you can get away with just doing this.
- Right, right, right, exactly right, Bob.
If you had fractured your wrist,
your fingers may have been moving all the time in the cast.
Sometimes those fingers are already
isolated in the cast and you can't.
Then they're probably gonna be stiff
and then you'll do this.
Good point.
And you do it on each finger.
Each joint you may need to do it.
- Each joint of the finger.
- And I've had people only one or two fingers are stiff
and the other ones, depending on the injury.
But if they are stiff, you do wanna isolate each joint.
- So you're always grabbing
above the joint basically
and pulling above the joint
and pulling.
- The ones on the tip,
a lot of people don't think about that
but you really need to get in and work that sometimes too.
Especially on those first two fingers,
that's very functional.
- So you should be able to get in, you know,
your fingers should be able to go
all the way into the crease
if you're able to have full flexion.
- There you go.
And then the thumb; don't forget about the thumb.
That's a little different than the fingers
but make sure you can work it
right to left if you will.
- It's got full circumduction there basically.
- Forward and backwards.
And there's a joint right here,
a joint here, and a joint there.
So there is three joints on the thumb.
This one a lot of people aren't aware of
so you wanna make sure that's going.
And it's different than the fingers.
It's not as clear.
Work it this way.
This joint only goes one way
and this joint is a hinge joint as well.
So, work all those 10-20 reps.
Start from the wrist, go out to the fingers.
It may take you at the beginning
if you have a full range of motions
from the fingers to the wrist,
you might be doing this for, you know,
three to five minutes.
You'll get better at it; it loosens up.
And then, back to normal.
- What's your number five there?
Is that open, close-
- Oh yes, that's just a general.
Once you get done, just open and close, do some circles.
Just to finish it up.
And to the point, if you can shake it out,
you can do that a little bit.
You won't be able to do that initially.
- Shake it off, shake it off.
(both laugh)
- Whatever it takes to trip your trigger.
- All right, thanks everybody for watching.
- Enjoy the day.